Oct 20, 2012 Volume 380 Number 9851 p1359 – 1444 e7
Tuberculosis—from ancient plague to modern-day nemesis
This week sees the launch of the WHO Global Tuberculosis Report2012. This annual report provides the latest data and analysis about the tuberculosis epidemic and progress made in prevention, care, and control of the disease from 182 member states and a total of 204 countries and territories with over 99% of the disease burden. As well as improvements in measurement and reporting, which include more country and prevalence surveys, for the first time the burden of tuberculosis in women and children and estimates of lives saved by the implementation of collaborative tuberculosis/HIV activities are documented.
Unexpected high levels of multidrug-resistant tuberculosis present new challenges for tuberculosis control
Most international recommendations for tuberculosis control have been developed for multidrug-resistant (MDR) tuberculosis prevalence of up to around 5%. Yet we now face prevalence up to ten times higher in some places, where almost half of the patients with infectious disease are transmitting MDR strains of Mycobacterium tuberculosis.1 The highest prevalence of MDR tuberculosis documented to date, 47·8%, was reported in 2011, in Minsk, Belarus.1 Among patients with infectious (smear-positive) pulmonary disease, MDR tuberculosis was seen in 35·3% of newly detected cases and in no less than 76·5% of previously treated patients.